The New England journal of medicine
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Editorial Comment
Prophylactic antimicrobial agents and the importance of fitness.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of three fluid solutions for resuscitation in dengue shock syndrome.
Dengue shock syndrome is characterized by severe vascular leakage and disordered hemostasis and progresses to death in 1 to 5 percent of cases. Although volume replacement is recognized as the critical therapeutic intervention, World Health Organization management guidelines remain empirical rather than evidence-based. ⋯ Initial resuscitation with Ringer's lactate is indicated for children with moderately severe dengue shock syndrome. Dextran 70 and 6 percent hydroxyethyl starch perform similarly in children with severe shock, but given the adverse reactions associated with the use of dextran, starch may be preferable for this group.